Talk:Borderline personality disorder/Archive 4

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Society and Culture?

If a book or movie has a character who has been specifically diagnosed with BPD, including them in this section MIGHT be of benefit. But most of the characters listed are just people who "could have" BPD, based on the opinions of some viewers who may or may not be expert and who admit that the characters don't QUITE fit. How, exactly, is this any more encyclopedic or informative than the discussion my friends and I had last week, accompanied by 4 bottles of red wine, about whether George W. Bush really meets the definition of a sociopath?

As someone with BPD who has never harmed or threatened another person in her life, I am sick and tired of being compared with Alex from Fatal Attraction. When I tell men who are interested in me that I have BPD and they look it up online, guess what they see first? Would you include Jason from the Friday the 13th movies in the "Society and Culture" section on schizophrenia? It's just as valid.

Including this section is not only of questionable legitimacy, it furthers the stigmatization of people who, through no fault of their own, find themselves trying to manage this disorder. —Preceding unsigned comment added by 98.178.152.83 (talk) 23:17, 1 June 2010 (UTC)

We just follow what the sources say. In the case fo Fatal Attraction, the cited source is Robinson, David J. (1999). The Field Guide to Personality Disorders. Rapid Psychler Press. p. 113. Are you challenging the accuracy of that citation? Dlabtot (talk) 23:21, 1 June 2010 (UTC)

I don't know how accurate the citation is; I don't waste my time reading books in which alleged doctors "diagnose" fictional characters. My question was whether these additions to the discussion increased the knowledge people had of the subject. The discussion itself acknowledged that the cited characters DIDN'T meet the criteria for BPD, they just maybe perhaps displayed some attributes. It's a discussion that's designed to sensationalize the diagnosis and demean those who suffer from it. If being published is the only standard for being a wikipedia citation, there are a whole lot of wolfman babies out there. 98.178.152.83 (talk) 23:37, 1 June 2010 (UTC)

If you aren't disputing the citation than I'm not sure what you are talking about. You don't like it, but you haven't read it... so what is your point? Ok, you are 'sick and tired of being compared with Alex from Fatal Attraction'. So what? I'm sick and tired of being compared with Fabio Lanzoni, Albert Einstein and Mohandas Gandhi, but that doesn't send me scurrying to those articles to complain. Dlabtot (talk) 23:58, 1 June 2010 (UTC)

What I'm talking about is that it's unprofessional and unethical to characterize actual medical conditions by using movies. Remember Bill Frist and Terri Schiavo? He was the physician/member of congress who watched home movies of a woman in a pervasive vegetative state, then gave his "learned opinion" that Schiavo was not in PVS and was actually responding to her environment. Frist was roundly criticized as unethical for giving a medical opinion about a patient he had not examined. It was pretty much the end of his political career. So, if giving a medical opinion about a real person, based on videos, is unethical, how much worse is it for a physician to try to fit fictional characters to diagnoses? Especially when the people who have created and portrayed those characters deny the connection? —Preceding unsigned comment added by 98.178.152.83 (talk) 23:58, 11 June 2010 (UTC)

We are writing an encyclopedia here, specifically an article about the BPD diagnosis. I can't see how anything you've written is at all relevant to that end. If you want to argue the ethics of David J. Robinson's books, this is not really the place to do it. Dlabtot (talk) 04:37, 12 June 2010 (UTC)

The book is one wwritten by a psychiatrist discussing films portraying psychiatric conditions. It is worth discussing them as they are popularly seen to represent teh condition, hence discussing them and discussing inaccuracies is important rather than ignoring. Casliber (talk · contribs) 03:53, 2 June 2010 (UTC)

I realize, from reviewing this page, that there are a couple of people who seem to have a real investment in linking the Alex character in Fatal Attraction to actual BPD. Nevertheless, you're both describing ONE book by ONE person about the condition. Dr. Robinson seems to specialize in the reduction of psychiatry to mnemonics and cartoons. That's hardly a recommendation. I also can't find him listed as a licensed psychiatrist here in the U.S. Moreover, Casliber, there was a time when black people were "popularly seen" to be inferior to whites. Does that mean that we need to continue to discuss that viewpoint and its inaccuracies, or can we all just agree that racism is rubbish and stop talking about it like it's a legitimate point of view? The reason BPD is "popularly viewed" the way it is is because people like you and Dlabtot continue to perpetuate inaccurate perceptions. I am not the first person to object to this behavior. —Preceding unsigned comment added by 98.178.152.83 (talk) 23:07, 11 June 2010 (UTC)

Frankly I don't believe that any diagnosis based on the DSM has any validity whatsoever, but my opinion is not actually relevant here. Dlabtot (talk) 04:37, 12 June 2010 (UTC)

Don't you think it is better to mention the film and then explain why it is not a good representation rather than ignore it. I have seen it discussed in other psychiatric articles so I felt this approach was best. Casliber (talk · contribs) 07:18, 12 June 2010 (UTC)

ps; for the record, the two examples removed I think I can source, however both are not great examples so I don't see them as a high priority. I felt that neither really encapsulated the syndrome well (however if someone else is desperate to source them...). Some secondary discussion is always good. Casliber (talk · contribs) 21:39, 10 October 2010 (UTC)

I don't see anything to indicate that this book is not reliable, or that it is represents a minority opinion, or that its author is considered to be fringe. IP argues that this book has negative consequences for BPD sufferers...well, that's not relevant, unless IP can demonstrate that this viewpoint is not a mainstream view in the current psychological field. Let me go back to the IP's claim about "inferiority" of blacks in historical scientific literature. I would argue that, if Wikipedia had been written in the mid 1800s, it would, in fact, have been correct for Wikipedia to report that blacks are inferior according to the psychological literature of the time. Now, I don't agree with that claim, and neither did some others at the time. But Wikipedia's job is to summarize and repeat what reliable sources have said, not to make our own judgment about what is or isn't correct. If you have other reliable sources that you believe that can be added to the article to provide balance, then feel free to do so--articles are required to represent all relevant viewpoints in proportion to their relative importance. Alternatively, if you can show why this is not a reliable source, it can be removed. One thing you could do is ask at either [[WP:Wikiproject Psychology}the Psychology Wikiproject]] or at the reliable sources noticeboard. If either or both of those considered these to be unreliable sources, removing would then be appropriate. Qwyrxian (talk) 01:35, 11 October 2010 (UTC)

Add http://www.scientificamerican.com/article.cfm?id=when-passion-is-the-enemy ?

Add http://www.scientificamerican.com/article.cfm?id=when-passion-is-the-enemy [1] ? 99.155.146.1 (talk) 01:00, 13 July 2010 (UTC)

To me, this seems more like a link that could be added to the open directory project (if it is not already there). What do you think is in the Scientific American article that cannot be integrated in the wikipedia article (see: WP:ELYES number 3)? Lova Falk talk 14:17, 13 July 2010 (UTC)

BPD needs advice

I have been diagnosed with BPD twice in the last two years yet have been unable to obtain treatment or even direction as to what i need to do in order to get better. I'm tired of living like this and want desperately to get better. —Preceding unsigned comment added by 75.155.111.68 (talk) 06:02, 14 July 2010 (UTC)

i too have been diagnosed with bpd and my family seems to think that i have multiple perosnalities. however i dont have the memory loss associated with it. i was just wondering can bpd manifest similarities? my husband even says my accents change when i talk and total different perosnatlites emerge. any info would help. —Preceding unsigned comment added by 69.176.22.196 (talk) 21:36, 6 October 2010 (UTC)

I have removed your email addresses--never leave your email address on open boards on the internet. Please note that Talk pages are where we improve the article, not a place to ask general (forum-like) questions. I recommend contacting a healthcare professional, or, if you want other amateur's opinion, going to a website that specialized in hosting conversations between people with medical problems. Thanks, Qwyrxian (talk) 22:22, 6 October 2010 (UTC)

danger lavel

on a scale of 1-10 how do the medical proffession and society in general view people with bpd,are they viewed as dangerous?86.20.38.212 (talk) 12:18, 26 September 2010 (UTC) —Preceding unsigned comment added by 86.20.38.212 (talk) 12:11, 26 September 2010 (UTC)

Hi. Talk pages of articles are not the place to ask questions--they only exist to help improve the article. You can try the Reference Desk, although I'm not sure if they can answer your question, since you're really asking for an opinion, not a fact. (I'll leave this message up for a while, but we can remove it later per WP:NOTFORUM). Qwyrxian (talk) 14:12, 26 September 2010 (UTC)

The statistics can't be right

The statistic that 1-2% of the "general population" has BPD is repeated in this article, as well as the statistic that the eventual suicide rate among people with BPD is 8-10%.

If we multiply these numbers, it says that 8-20 people in 1,000 suffer from BPD and kill themselves.

Suicide rates vary considerably by country, but in the United States, en.wikipedia.org/wiki/List_of_countries_by_suicide_rate gives the rate (per year) for the US as 17.7 per 100,000, and most of the world population is probably within a factor of 2 of this. Averaged a lifetime of roughly 70 years, this would put suicide as the cause of death of about 11 per 1000 of the US population. This seems to imply that almost all suicides are by borderline patients.

Other sources give estimate that about 1/3 of completed suicides are by borderline patients.

These figures do not fit together. I suspect that for the estimate that 8-10% of people with BPD who commit suicide is based on more restrictive criteria than the estimate that 1-2% of the general population has BPD.

There's a tendency for unsourced statistics to be published, then repeated with the unsourced publication cited as the source. For instance, in this article, citation 24 is given as the source of the figure that 8-10% eventually commit suicide, but citation 24 does not give sources. It's wrong to keep broadcasting potentially misleading statistics. —Preceding unsigned comment added by Quintipus (talk • contribs) 14:42, 23 October 2010 (UTC)

borderline personality disorder

Is it common for someone showing many symptoms of BPD to not realize he or she has it, making it difficult to receive treatment? What can family and friends do to help?Sweetleslie540 (talk) 22:58, 31 October 2010 (UTC) I appologize by asking a question. I'm new to this whole thing, so please don't feel the need to batter me because I've asked. If someone is willing to help, I'm grateful, otherwise, please don't bash and move on.Sweetleslie540 (talk) 23:27, 31 October 2010 (UTC)

No bashing, but Wikipedia is not a place to ask questions about topics. You may be able to get help at the Reference Desk, although they don't always have info about these types of issues. Alternatively, you may want to look to another website that specializes in question and answer format. Qwyrxian (talk) 23:30, 31 October 2010 (UTC)

Copyright violation

I removed one sentence left from an add of 14 June 2008, the diff of which is here, where authors are parenthetically mentioned, but they do not appear in refs or bibliography or anywhere else in the article. That's clearly copied from somewhere, or Anonymaus forgot to finish the job by providing the corresponding bibliographical entries. Am quite surprised that it stayed this long. I tried a Google search of the original, but that's not easy, since everyone and his brother are copying this article all over the Net. --Jerome Potts (talk) 11:40, 1 November 2010 (UTC)

You mean the listy sentence of former names presumably? That information would have come from some book somewhere but it might have been a mere list there too - agree that we can't tell if and how it was rewritten. We weren't quite as rigorous in inline sourcing everything then and Anonymaus was a comparatively new editor at the time. Casliber (talk · contribs) 19:04, 1 November 2010 (UTC)

PS: That's an interesting way you've rejigged the ref section. Not seen that before. I normally have the inline ref section with the book numbers plus individual journal articles and books only used once, and a section below that for books used multiple times (the page numbered refs of which are in the above section). This way now also has an explanatory note in there as well. Casliber (talk · contribs) 19:07, 1 November 2010 (UTC)

Referencing

Wondering why we are using two reference formats? Cannot we not stick with one... Doc James (talk · contribs · email) 01:00, 7 January 2011 (UTC)

Umm...historical? Sometimes happens with these big articles. I was using "Smith J" alot before, but it jars a little when up agains "Smith, John" - I like to get boh names if I can find them...Casliber (talk · contribs) 02:06, 7 January 2011 (UTC)

Invitation to edit

It has been proposed that Borderline personality disorder be part of the trial of a new template; see the green strip at the top of Pain where it has been in place for a couple of months. The purpose of this project is to encourage readers to edit, while equipping them with the basic tools. If you perceive a problem with this, or have any suggestions for improvement, please discuss at the project talk page. --Anthonyhcole (talk) 09:28, 10 January 2011 (UTC)

Not sure it's a great choice for this one but go ahead/why not...Casliber (talk · contribs) 21:06, 10 January 2011 (UTC)

Let me know if you think it's causing problems. --Anthonyhcole (talk) 11:57, 12 January 2011 (UTC)

Society and culture section

This entire section is clearly just fluff. Pretend diagnoses of fictional characters have no place in an article of this nature. This section reads like a film fan magazine article. I have read the reasons given to retain this section, and these reasons are wholly inadequate. Keep Star Wars to Star Wars' articles please. 123.243.37.236 (talk) 04:46, 18 January 2011 (UTC)

If we were "diagnosing" them ourselves, you would be correct; but since reliable sources have claimed that they fit the profile, the section is appropriate for this article. This is the same as having fictional characters listed as "residents" of cities, or as "having" other diseases, or as being "members" of organizations. As long as we stick with only what is reliably sourced and don't let the section grow overlong, it should stay. Qwyrxian (talk) 08:37, 18 January 2011 (UTC)

This still does not explain why "diagnosing" imaginary characters - a ridiculous fantasy in itself, whether by reliable sources or not - is in any way relevant to the article. The mere fact that a "reliable source" has "said something" doesn't automatically make it worthy of inclusion. This section simply has no value. Render unto Star Wars... 123.243.37.236 (talk) 11:33, 18 January 2011 (UTC)

The inspiration for much fiction is derived from real life. The material has been discussed in books written by psychiatrist who discuss and analyse the works. Cultural representation by secondary sources is worthy of inclusion. Casliber (talk · contribs) 11:36, 18 January 2011 (UTC)

You are claiming that an imaginary space alien who wears a black cape and helmet, lives in a Death Star and blows up planets is a valid "Cultural representation" of the symptoms of BPD. Or a violent knife-wielding bunny-boiler. This is just BS. You also claim that these characters are derived from real life examples of people suffering from BPD. Again, total nonsense. I'm sorry, but you have said nothing to change my view that this section is irrelevant twaddle at best, and actually so misleading as to be harmful to the quality of this article at worst. For that matter, I or anyone else could just as easily cite a reliable source, actually previously mentioned on this page and conveniently ignored, who states quite categorically that the Darth Vader character does not suffer from BPD. This section has no scientific or medical relevance or legitimacy at all. Do the article a favour and dump it. 123.243.37.236 (talk) 14:06, 18 January 2011 (UTC)

Pay-as-you-go-references

Hello, I stopped by today to add a decade old reference regarding the paradox of expressed emotions in caregivers. It is presently #18 and the link is still open as of today. But once it starts getting a lot of site hits I expect the APA will close it;a number of other references here to the journals are already closed except to subscribers and active payers. So one of the regular article editors may wish to see what could be done to find free references which support the material. Thanks, kudos to all. This is a pretty well written article. Trilobitealive (talk) 22:47, 10 February 2011 (UTC)

A character disorder is not a mood disorder

But I'm not going to waste time on this as the whole Psycholgoy category is a mess anyway -- an embarrassment. --Mattisse 01:01, 8 September 2007 (UTC)

User:DashaKat, thank you for removing the Category:Mood Disorder. I was getting nowhere with my attempts. --Mattisse 14:36, 8 September 2007 (UTC)

It's a personality disorder, at least according to the DSM. "Character disorder" is a bit outdated. Rapunzel676 (talk) 03:49, 21 February 2010 (UTC)

I have to say that suicide attempts are not just in extreme cases. I have Borderline Personality Disorder and I do not have it to that extent, however, I tried to kill myself when I was twenty three. This is because I did not have any therapy, and was unaware that I had the disorder. My point is that it's not purely extreme cases. ~~Molly ~~23 October 2010 —Preceding unsigned comment added by 184.58.112.145 (talk) 02:19, 24 October 2010 (UTC)

Suicidal cases are considered extreme. I understand that you have a difficult disorder to deal with, however the portion of people with BPD who are suicidal is far smaller than those who are not. In addition, suicidality is not a diagnostic criterion for the disorder. It therefore has to be considered a criterion for extreme cases (rarity + symptom outside the designated criteria = extreme case). Relleka (talk) 06:36, 3 March 2011 (UTC)

A 2011 review article in the Lancet

Leichsenring F, Leibing E, Kruse J, New AS, Leweke F (2011). "Borderline personality disorder". Lancet. 377 (9759): 74–84. doi:10.1016/S0140-6736(10)61422-5. PMID 21195251. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) --Doc James (talk · contribs · email) 06:53, 3 March 2011 (UTC)

It's a somewhat noncommittal abstract...I'll take a look sometime. Casliber (talk · contribs) 12:26, 3 March 2011 (UTC)

What if...

What if BPD is caused by the limbic system being in a perpetual state of flight or flight due to a structural flaw in the human body? This could cause a distortion in perception and what if that causes the conscious mind (matter) to compete with the unconscious mind (antimatter)for oxygen? Emotions could the conscious mind desperately making an attempt at increasing or decreasing cerebral metabolism and people with BPD haven't fully gained consciousness and are in a perpetual state of REM/BETA, and are only partially conscious with the help of adrenaline and binge eating and drugs helps them get to sleep? I believe I broke out and it took me 23 years. And now I'm fast. Very fast to the point the I have to slow down and appear to walk in slow motion. I may be in a perpetual state of THETA now but I can't be too sure. I don't get depressed or get anxiety and I can disassociate the pleasure of an orgasm completely just with breathing techniques. Think about when you're in a car accident and time slows down- I'm like that during most waking hours but my perception changes with lighting and temperature shifts. Pretty much like a reptile. TH3 D3FIANT ON3 —Preceding unsigned comment added by 24.196.226.144 (talk) 04:43, 11 April 2011 (UTC) <!-(CONSCIOUS) [WILL] (SUBCONSCIOUS)-->

Fascinating theory, but Wikipedia does not publish original research. If you have any reliable medical sources relating to this theory/topic, feel free to share them and we can consider them for inclusion. Qwyrxian (talk) 05:30, 11 April 2011 (UTC)

Emotionaly unstable personality disorder

isnt EUPD a separate disorder all together? an impulsive type and a borderline type shouldn't this disorder have its own page? or be mentioned more. —Preceding unsigned comment added by 114.72.221.166 (talk) 11:53, 11 April 2011 (UTC)

Edit request from 86.134.64.26, 12 April 2011

Please capitalise the title of this article!

Thank you :)

86.134.64.26 (talk) 18:43, 12 April 2011 (UTC)

Not done: see WP:TITLEFORMAT. "Borderline personality disorder" is not a proper noun. — Bility (talk) 20:33, 12 April 2011 (UTC)

Edit request from Langejr, 16 April 2011

I am requesting to submit information from an established and reviewed medical article entitled "Effectiveness of Pharmacotherapy for Severe Personality Disorders: Meta-Analyses of Randomized Controlled Trials." Author= Ingenhoven T M.D. etal; Source= Journal of Clinical Psychiatry 2010 71(1):14-25. The edit will modify the Medical Treatment portion of the talk page on Borderline Personality Disorder and provide evidence based data regarding the usage of Mood Stabilizers in the treatment of specific symptoms of Borderline Personality Disorder, mainly the evidence supporting the usage of mood stabilizers in treating impulse-behavior dyscontrol and anger.

Langejr (talk) 16:50, 16 April 2011 (UTC)

You need to state exactly what you want to add/change. There's no way for us to allow a specific editor to change the article; however, if you list the exact change requested, then we can add it for you. Qwyrxian (talk) 16:51, 16 April 2011 (UTC)

Please do, Langejr. That would be great. Put your proposed text here and we'll help you format it for the article. The reference is to PMID 19778496. --Anthonyhcole (talk) 17:15, 16 April 2011 (UTC)

Proposed Text: Under 4 Management - 4.2 Medications - Please add in new paragraph under existing one.

The use of psychotropic pharmacological medications (including antipsychotic, mood stabilizers, and antidepressants) in the treatment of Borderline Personality Disorder is controversial. However, a recent meta-analysis analyzing double-blind placebo controlled randomized trials from 1980 to 2007 provides some evidence for the use of such drugs in the treatment of specific symptoms in severe personality disorders (including Borderline Personality Disorder and Schizotypal Personality Disorder).[2] Of note, the analysis reports significant improvement in impulse-behavior dyscontrol and anger dysregulation with the use of mood stabilizing drugs such as valproate, carbamazepine, topiramte, and lamotrigine. The study results found the pooled effect size of mood stabilizers on impulsive-behavioral dyscontrol (SMD=1.51; 95% CI, 0.42-2.59) to be significant (P < 0.1) and qualified as very large. Results of the pooled effect size of mood stabilizers on anger (SMD=1.33; 95% CI 0.43-2.22) was also found to be significant (P<0.1) and qualified as large. — Preceding unsigned comment added by Langejr (talk • contribs) 20:59, 16 April 2011 (UTC)

There are apparent contradictions between the January 2010 meta-analysis you are citing [2]

Mood stabilizers have a very large effect on impulsive-behavioral dyscontrol (6 PC-RCTs; SMD=1.51) and anger (7 PC-RCTs; SMD=1.33), a large effect on anxiety (3 PC-RCTs; SMD=0.80). [...] Mood stabilizers have a more pronounced effect on global functioning (3 PC-RCTs; SMD=0.79) than have antipsychotics (5 PC-RCTs; SMD=0.37).

and the June 2010 systematic review the article presently relies on [3]

The available evidence indicates some beneficial effects with second-generation antipsychotics, mood stabilisers, and dietary supplementation by omega-3 fatty acids. However, these are mostly based on single study effect estimates. [...] Total BPD severity was not significantly influenced by any drug. [...] Conclusions have to be drawn carefully in the light of several limitations of the RCT evidence that constrain applicability to everyday clinical settings...

The latter warns that the evidence for effect is thin (single studies), urges caution in interpretation and clinical application, and sees no significant improvement in "total BPD severity" from any drug. The former does not express reservations about interpretation or clinical application of the data, and uses the word "pronounced" when describing the impact of mood stabilizers on global functioning, which one would expect to be somewhat correlated with "total BPD severity."

I haven't read the papers; this is from the abstracts. If a reading of the papers can explain these apparent discrepancies, I'm fine about inserting this good news into the article. But if they can't be reconciled, I'd prefer to stick with the present, more timid, Cochrane Review claims rather than the bolder Ingenhoven et al. claims.for now; until the efficacy results have been replicated. --Anthonyhcole (talk) 21:34, 16 April 2011 (UTC)

Langejr welcome, I guess we also have a problem in that the primary and secondary source rather contrast in their findings. For some reason I cannot access the fulltext currently but reading the abstract am concerned there is no double blinding mentioned in the studies they have reviewed, and the combining of two personality disorders, one of which (schizotypal) is thought to be much more closely allied to the psychoses like schizophrenia. I'll try to get the fulltext soonish. The mood stabiliser bit seems counterintuitive to me too (unless the lack of blinding means that folks feel like taking meds twice daily has a more significant placebo effect than once.....must look into that) Casliber (talk · contribs)

Since this is getting some good discussion, I've switched the "answered" parameter to "yes", so that the article doesn't appear in the "articles with SP edit requests" category. The discussion should certainly continue, of course. Qwyrxian (talk) 10:04, 18 April 2011 (UTC)

Edit request from 134.115.2.117, 1 May 2011

Hi Under the gender section, the citation that women are three time more likely to be diagnosed with BPD than men comes from the DSM-IV-TR (American Psychiatric Association, 2000, pg 708).

134.115.2.117 (talk) 07:36, 1 May 2011 (UTC)

Done — Bility (talk) 21:07, 2 May 2011 (UTC)

Archiving

Since this talk page is so long, I'm turning on auto-archiving, so messages older than 90 days will be moved to the archive sub-pages. This will make it easier to follow discussions. Let me know if there are any objections. Qwyrxian (talk) 13:10, 11 April 2011 (UTC)

Where are those? —Preceding unsigned comment added by 108.4.19.137 (talk) 05:13, 24 May 2011 (UTC)

Thanks for noticing; it wasn't showing up properly because the older, manual archives made in 2006 & 2007 were not named the same way that we currently name archives. I've moved the old pages to conform to the current naming scheme. There's now a box in the upper right, just below the Wikiproject info and to the right of the To Do list, that has all of the archives listed. For some reason, there is no Archive 3, but I don't believe any old information is missing. Qwyrxian (talk) 05:43, 24 May 2011 (UTC)

Misuse of term

When referring to Star Wars, you use the term hexology. The correct term for a series consisting of six is hexalogy 76.179.134.194 (talk) —Preceding undated comment added 14:33, 2 June 2011 (UTC).

Edit request from Gyulafekete, 18 June 2011

The section:

Borderline personality disorder was once classified as a subset of schizophrenia (describing patients with borderline schizophrenic tendencies). Today BPD is used more generally to describe individuals who display emotional dysregulation and instability, with paranoid schizophrenic ideation or delusions being only one criterion (criterion #9) of a total of 9 criteria, of which 5, or more, must be present for this diagnosis.

Should read:

Borderline personality disorder was once classified as a subset of schizophrenia (describing patients with borderline schizophrenic tendencies). Today BPD is used more generally to describe individuals who display emotional dysregulation and instability, with paranoid ideation or delusions being only one criterion (criterion #9) of a total of 9 criteria, of which 5, or more, must be present for this diagnosis.

i.e. the word Schizophrenic should not be present. Paranoid ideation is the correct term. Paranoid schizophrenic already implies the person has schizophrenia. This may cause alarm and confusion swell as being incorrect. Gyulafekete (talk) 15:37, 18 June 2011 (UTC)

 Done Seems straight-forward enough. ^Avic_ennasis @ 17:45, 16 Sivan 5771 / 18 June 2011 (UTC)

Marilyn Monroe=

according to this [4] article, Marlyn had it. Kittybrewster ☎ 16:43, 30 March 2011 (UTC)

That article is a dead link. There are a number of celebrities that show signs of personality disorder. However, wikipedia is not the place for such gossip. Reub2000 (talk) 03:43, 19 June 2011 (UTC)

Semi-protection?

It says that this article was semi-protected sometime last October because of excessive vandalism, but I didn't see anything in the talk archive. Looking at the entries above, it looks like the newbies have many constructive edits to add. Is this really justified? Reub2000 (talk) 03:47, 19 June 2011 (UTC)

You're always welcome to request removing semi-protection. :-) The best place would either be the protecting admin's talk page or at WP:RUP. ^Avic_ennasis @ 07:41, 17 Sivan 5771 / 19 June 2011 (UTC)

Okay, we can give it a trial - a lot of medical articles seem to erode or amass material at a fairly steady rate - not a problem over a week or two but can be a headache to monitor over months to years. We can see how it goes. Casliber (talk · contribs) 04:51, 20 June 2011 (UTC)

Hi, I'm a (relative) newbie who will likely come and go on Wikipedia occasionally. I did some edits on this article in the section that was titled, "Mediators and Moderators," which was tagged for being overly technical and hard for a nonspecialist reader to understand. While I'm not the author of the original section and hope the author reviews my edits, I hope I have made a step in the direction of a clearer section that's relevant to the article topic. I didn't know the article was semi-protected and am not even sure what that means, but hope someone will let me know if they have any concerns about my edits, thanks. Grebe39 (talk) 03:34, 30 July 2011 (UTC)

I like it. I just made some minor changes--section titles only get caps on the first word (unless there's a proper noun); we don't include the years of the article publishing in the text like journal articles do; and refs are usually, though not always, better at the end of sentences. Semi-protection means that only editors who have a registered account (i.e., not editing as an anonymous IP) and have been editing for at least 4 days and 10 edits can edit the article. You've already passed that threshold, which is why you were able to edit the article. It's used mainly to stop vandalism from anonymous editors. I felt your version was such an improvement that you've fixed the problem that the template mentioned, so I removed it. Thanks! Qwyrxian (talk) 12:06, 31 July 2011 (UTC)

The Big Hit?

If anyone agrees, I would like to add "The Big Hit" to the list of movies, which are "attempting to depict characters with the disorder", due to its main character. 83.17.84.82 (talk) 08:25, 13 August 2011 (UTC)

I'm not familiar with the movie but, if it warrants inclusion in the article, you'll need to cite a reliable source that discusses its relevance to BPD. For the kind of appropriate sources, see WP:RS and WP:MEDRS, and for how to include it, the existing references to BPD in film and television do it quite well – emulating those would be OK, I think. --Anthonyhcole (talk) 10:21, 13 August 2011 (UTC)

I replied to your query on my talk page. --Anthonyhcole (talk) 23:37, 13 August 2011 (UTC)

Is scheming/manipulation a symptom?

I've read that high IQ's often go with BPD; is it characteristic of higher IQ BPD's to industrially, write thick 'novels' with their thinly disguised family members in it? Do military entrance exams screen for BPD? ∞ focusoninfinity 03:42, 17 August 2011 (UTC) — Preceding unsigned comment added by Focusoninfinity (talk • contribs)

All of these are interesting questions, but, alas, not ones we're equipped to answer. Article talk pages like this one are purely for discussions of how to improve the article, not a general forum for discussion or Q&A. You may want to try the Reference Desk and see if they can help there. Qwyrxian (talk) 05:14, 17 August 2011 (UTC)

Carbamazepine (Tegretol) in the treatment of Borderline personality disorder.

In the medications section, the efficacy of mood stabilizers in treating borderline personality disorder needs to be considered. It is very misleading to simply dismiss mood stabilizers as clinically insignificant ("weak") in the treatment of BPD. Affective instability and emotional dysregulation are among the most serious symptoms of this disorder, and can be modulated by an effective mood stabilizer, in particular Carbamazepine (Tegretol), which is used increasingly by specialists with clinically significant results. Evidence for this is as follows:

Denicoff KD, Meglathery SB, Post RM,... - Biological Psychiatry Branch, National Institute of Mental Health, Bethesda, MD. J Clin Psychiatry. 1994 Feb - Efficacy of carbamazepine compared with other agents: a clinical practice survey

Carbamazepine. Gardner DL, Cowdry RW. - Am J Psychiatry. 1986 Apr - Positive effects of carbamazepine on behavioral dyscontrol in borderline personality disorder.

http://www.aapel.org/bdp/BL_molecules_US.html

Although medical treatment of the borderline personality disorder is more an art than a science, given doctors' general lack of knowledge on the subject compared to more "mainstream" disorders such as bipolar disorder, to report that evidence for benefits of mood stabilizers to BPD sufferers is "weak" is simply untrue, and serves to only mislead readers of this otherwise excellent article. To say that omega 3 fatty acids and antipsychotics, both certainly of little benefit to a BPD sufferer, are in the same bracket as mood stabilizers in terms of clinical efficacy, is simply untrue based on performed clinical trials.

Please verify all sources of evidence above and allow the appropriate changes to be made accordingly.

94.13.13.164 (talk) 07:48, 3 September 2011 (UTC)James Brannigan 03 Sept 2011

James, I have taken the liberty of slightly reformatting your comment and linking to the articles you cite, please feel free to undo that if it was impertinent. I know very little about the subject. The only edits I've made to the article are basic housekeeping stuff [5]. Health-related information on Wikipedia is based on recent authoritative systematic or literature reviews, per our medical reliable sources guideline. The existing paragraph cites such a review

Stoffers J, Völlm BA, Rücker G, Timmer A, Huband N, Lieb K. (2010) Pharmacological interventions for borderline personality disorder. Cochrane Database Syst Rev. 16 (6) PMID 20556762

and seems to be paraphrasing this statement from that review

The findings were suggestive in supporting the use of second-generation antipsychotics, mood stabilisers, and omega-3 fatty acids, but require replication, since most effect estimates were based on single studies. The long-term use of these drugs has not been assessed.

May I suggest we replace the existing paraphrase with an exact quote (in "quotation marks") or with a paraphrase that more accurately reflects the "suggested support" for these drugs and the need for more evidence?

(Discussions on Wikipedia talk pages can range over several days or weeks, depending on schedules and time zones of different editors.) --Anthonyhcole (talk) 09:41, 3 September 2011 (UTC)

Anthonyhcole, thank you for finding those evidence links online - they do exist in printed format but I was unable to locate digital (online) format particularly due to their age. I appreciate you finding them as this will make it a lot easier to edit now. As I mentioned previously the most comprehensive resource I have found on borderline personality disorder is currently made by psychiatrist Dr Leland Heller M.D.. All assertions on that site are backed up by verifiable evidence which is available online. Since not many know certain facts about the BPD, it is necessary to trust the opinions of specialists such as Dr Heller rather than simply paraphrase a single piece of research. If, of course, there are trials in which mood stabilizers, Carbamazepine in particular, have been shown to have "weak" benefits, then by all means let us reflect that in the article. At the same time, there is compelling clinical evidence both from published trials (as you have seen), as well as from expert opinion (psychiatrist specializing in BPD) that mood stabilizers may be of significant benefit to sufferers of BPD. For the sake of impartiality and the pursuit of facts, we must reflect the positive findings too.

As I have mentioned before, to ignore the benefits of mood stabilizers for a disorder whose main symptoms are emotional instability and impulsive behavior, is incorrect and misleading. There is even evidence that antidepressants such as fluoxetine as well as as needed antipsychotics such as haloperidol, may be of benefit. I have managed to find evidence online so I am improving at this, please find it here: http://www.ncbi.nlm.nih.gov/pubmed/1683641 . I was particularly eager to have Carbamazepine included in the article because its benefits are often overlooked, whereas most doctors would prescribe an SSRI as a first port of call anyway. However, the BPD involves a few systems which are out of sync, namely adrenergic, cholinergic, serotonergic and even dopaminergic systems which are ideally treated with carbamazepine, fluoxetine and low dose antipsychotics respectively. Of course, not every patient will be the same, for example, certainly not all patients will respond to or require an antipsychotic; some patients may have dysregulation in certain systems more than others, for no two brains are the same, and professional judgement of the psychiatrist always needs to be exercised as to which specific medications to use, however the essential point remains that medications must not be automatically discounted where they have been shown by various verifiable sources within wikipedia's guidelines to be of clinically significant benefit.

Borderline personality disorder medications are not simply effective for co-morbid conditions, they are effective for the condition itself. It could be quite dangerous for wikipedia to essentially state that there is little point in using any medications, leading some doctors to shy away from using medication whose efficacy has been proven by a variety of trials.

Please edit it as you see fit, since you are the editor; I would trust your judgement in light of the evidence presented.

I would be prepared to do further research on this matter using of course verifiable sources only, and if this means that I would have to familiarize myself with wikipedia's extensive syntax then so be it.

Thankyou for your patience (I did not mean to go on so long). 94.13.13.164 (talk) 11:07, 3 September 2011 (UTC)James Brannigan

The mood instability of borderline is a very different entity from that of bipolar disorder. And mood stabilisers main role is for the latter. I'll take a look at the literature you note. Casliber (talk · contribs) 11:32, 3 September 2011 (UTC)

this is anecdotal - a large number of anecdotal opinions but still pretty low down on the Evidence Based Medicine hierarchy. It is interesting though. Casliber (talk · contribs) 11:40, 3 September 2011 (UTC)

Okay, I've read the 1986 paper - it covered a small number of patients (16) over a short period of time (6 weeks), particularly so for paroxysmal events such as self harm. Furthermore, the side effects of the drugs themselves really put a cloud over the "double blind" status - carbamazepine, tranylcypromine, alprazolam and trifluoperazine all quite often have CNS and peripheral side effects that are fairly hard to confuse with each other, and I suspect that many of the patients might have trialled similar medications in the past. Also, the initial part of the study mentions testing four drugs, yet somehow numbers for the other three seem to have dropped out of the results. The fact that I am personally unsure of the study would be OR, but I note that it is not prominent in the other review articles, both of which are cautious about benefits and highlight weaknesses in data. Casliber (talk · contribs) 11:59, 3 September 2011 (UTC)

Of course borderline personality disorder is very much different from bipolar disorder, however this by no means negates the all mood stabilizers simply because their primary psychiatric use is in treating bipolar patients rather than borderline patients, just as we use SSRIs to treat anxious patients in addition to depressed patients. There are some overlaps in symptoms between the borderline and bipolar which often leads to wrong diagnosis. Ironically, this wrong diagnosis of a patient as bipolar instead of borderline may actually save lives since there is virtually no hesitance to use mood stabilizers when presented with a 'bipolar' patient. A borderline patient, on the other hand, would be less frequently encountered and many general practitioners will be using the authority of wikipedia as a source of research. The medications section is simply far too minimal and dismisses the use of pretty much all medications for treating borderline personality disorder in isolation, which is certainly not in the spirit of free research or reporting of facts. To simply dismiss the data as "weak" because you happen to believe it is weak, without even mentioning the positive outcomes from use of SSRIs and carbamazepine in particular, is not reporting facts. Thousands of borderline patients worldwide continue to show marked improvement with SSRIs and carbamazepine, however thousands more are being left untreated because doctors simply do not know enough about medications for borderline patients. Although I disagree with the data being weak, if you continue to maintain this view then by all means mention this, however in order to remain balanced and report facts we must also state the success in clinical trials as well as opinions of psychiatrists who have been treating this condition for far longer than any of us will have even heard of it. (Leland Heller M.D. has apparently been treating Borderlines since 1988). A list of more evidence is available here; the carbamazepine page you will have already seen, but the substantial evidence for fluoxetine is here: http://www.biologicalunhappiness.com/studies.htm . 94.13.13.164 (talk) 13:30, 3 September 2011 (UTC)James Brannigan

The review that the paragraph in question cites, is an ideal source as outlined in this: guideline. To best understand the constraints within which we are working here, it is important you read that guideline. The cited review is both recent and authoritative - the Cochrane collaboration has a good reputation for evidence analysis. My reading of the abstract (I can't access the article) is that the evidence for mood stabilizers is positive, but there is insufficient evidence to be confident that it is meaningful. Our article could probably express that more clearly, but that's about as much as we can say on the matter. To assemble primary sources and synthesize our own conclusions is strictly ruled out by the no original research policy. --Anthonyhcole (talk) 15:07, 3 September 2011 (UTC)

Yes, if that's all that can be said, then I believe fluoxetine, based on the studies in http://www.biologicalunhappiness.com/studies.htm , as well as carbamazepine deserve a mention. Surely the entire website to which I have repeatedly referred can be considered a secondary source by a qualified expert in this field - Dr Leland Heller M.D., who has been treating borderline personality disorder since the 1980s and has supported his own claims with the appropriate primary sources (clinical trials). His opinion is that it is very much clinically significant: http://www.biologicalunhappiness.com/WhyTegrt.htm . Do we ignore this psychiatrist's expert view, particularly when his own professional conclusion based on both reading of literature and substantial medical experience is made with such conviction to easily pass as clinically significant? What is the process here - shall we try to speak to him on the phone to get his opinion on the subject, or do we need to first contact his medical school in order to see and verify his professional qualifications first? I understand that I am an outsider and some editing practices here may be unfamiliar to me, but even after having read the guidelines, the evidence which is available in addition to the professional conclusions of perhaps one of the most experienced doctors who deals with borderline personality disorder, should certainly take prominence over the rash dismissal of medications for this condition by people who are not experts in this field. I am not a supporter of big pharma in any way, however I do recognize when there are certain more obscure disorders which simply aren't mainstream enough for people to write much about them, and thus many people with the disorder may continue to suffer if there is next to no possibility (as according to the current wikipedia article on borderline personality disorder medication) of any alleviation of the most painful symptoms of this disorder. At least, if we could make note that there have been some successful trials with carbamazepine and fluoxetine to treat the disorder, but that (as you rightly say) due to the relatively small size of the trials this may not be large enough to prove outright success with the broader population. The current section on medication should be expanded to at least mention these successful trials and what the few doctors who are actually specialists in borderline personality disorder are doing to treat their patients pharmacologically. 94.13.13.164 (talk) 16:01, 3 September 2011 (UTC)James Brannigan

Short review (secondary source) of initial study noting that although there is not one single drug, there are "drug responsive syndromes", i.e. the borderline personality disorder involves abnormalities in the brain's adrenergic, cholinergic, serotonergic and dopaminergic systems and depending on which abnormalities are present, the appropriate medication can be prescribed. Essentially it comes down to the "personality" disorder truly having biological abnormalities in the brain rather than simply "flaws" in character, and thus it is possible for medicines to treat sufferers. http://www.ncbi.nlm.nih.gov/pubmed/7906044 . Also, looking at http://www.ncbi.nlm.nih.gov/pubmed/19455483 , we see the typical treatment involving "atypical antipsychotics, antidepressant agents and mood stabilizers" which are conveniently for abnormalities in the brain's dopaminergic, serotonergic and adrenergic+cholinergic systems respectively. This is how the borderline personality disorder is treated by medication yet there is no mention of these medications' success, indeed they are simply dismissed in a very minimal section. 94.13.13.164 (talk) 16:25, 3 September 2011 (UTC)James Brannigan

The mainstay of treatment is (ideally) psychotherapy, however various factors such as availability and affordability, plus insight and willingness of the person to undertake it. The analogy that comes to mind is obesity and claiming the treatment is weight-loss drugs (rather than mentioning them as an adjunct to diet and exercise). There is significant uncertainty in what measured biological changes actually relate to, whether they are a cause or effect, and what we are actually addressing by trying to change them. Someone obviously will produce different brain chemicals while hyperaroused, are we reifying the changes too much? Casliber (talk · contribs) 20:55, 3 September 2011 (UTC)

Of course, however this section is medication, and there are, as evidence and professional opinion (as mentioned above many times) clearly indicates, medications which are effective in the treatment of the borderline personality disorder. Of course in the biopsychosocial model, psychotherapy is necessary, but so is the correct biology, and the borderline personality disorder (being somewhat of a misnomer) is a disorder which manifests itself as a result of abnormalities in any combination of the adrenergic, cholinergic, serotonergic and dopaminergic systems, abnormalities which need to be addressed before the optimal progress can be made via psychotherapy. If you read the literature provided, starting with Dr Leland Heller's summaries on the disorder and how to treat it, or even conducting independent research, the notion that the borderline personality disorder is not a concrete, biological illness as opposed to some character flaw only to be treated via psychotherapy, will quickly be proven as incorrect, misleading and in many cases where suicidal patients could only be helped by the right medication, downright dangerous. By measured biological changes, I don't mean the natural changes that of course would occur in the average brain in its various states, I mean, as the literature above has stated, fundamental abnormalities in the adrenergic, cholingergic, serotonergic and dopaminergic systems, biological abnormalities which can be treated with medicine. To suggest that all medicine is "weak" in treating borderline personality disorder is closer to suggesting that insulin is "weak" in treating diabetes, than your analogy concerning obesity and weight loss pills. Weight loss can be cured without any medication (co-morbid conditions aside), whereas borderline personality disorder requires medication due to fundamental abnormalities in brain chemistry. With all due respect I feel that this analogy does not show sufficient understanding of the condition as a biological disorder rather than some kind of character flaw which can be treated with psychotherapy alone. Perhaps this is why the medication section is pretty much non-existent - the assumption of psychological character flaw (psychotherapy only required) versus biological abnormalities resulting in character flaw (medication and psychotherapy required). As I said the name personality disorder is somewhat of a misnomer, indeed it is even mentioned in this very wikipedia article (I am surprised this got approved) that there are various other suggestions to re-name the borderline personality disorder to emotional dysregulation disorder (vel sim.). Such names would be far more appropriate and possibly make it much easier for those like me who are experienced in the treatment of this disorder to actually have very small, yet nonetheless pressing, changes approved on wikipedia! At the very least if you are unwilling to accept any changes (which in my humble opinion is contrary to the spirit of 'user edited' encyclopedia) then please set a team of medical experts the task of thoroughly researching the true nature (i.e. biological nature) of borderline personality disorder and hence, the success of SSRIs, mood stabilizers and (in some cases) antipsychotics in treating the abnormalities in the aforementioned systems. If this research were performed satisfactorily, then I have no doubt that the article would end up as it should be. As it stands, it is minimal, misleading, dismissive and ignorant of facts presented in both primary and secondary sources from respected and verifiable sources. 94.13.13.164 (talk) 22:32, 3 September 2011 (UTC)James Brannigan

Hi James. Per that guideline I referred to, on Wikipedia medical articles extreme conservatism is the general practice. The perceived tendency in favour of psychotherapy for BPD isn't the product of bias in that direction on the part of Wikipedia editors, but an attempt to reflect the current professional consensus on best practice. As I said, I'm no expert on this disorder, but as an educated reader it seems to me that this article succeeds in that endeavour, though it may benefit from more nuanced expression on some points.

• The UK National Institute for Health and Clinical Excellence (NICE) 2009 clinical guideline for the treatment and management of BPD says: "Drug treatment should not be used specifically for borderline personality disorder or for the individual symptoms or behaviour associated with the disorder (for example, repeated self-harm, marked emotional instability, risk-taking behaviour and transient psychotic symptoms)." but "Drug treatment may be considered in the overall treatment of comorbid conditions." and "Review the treatment of people with borderline personality disorder who do not have a diagnosed comorbid mental or physical illness and who are currently being prescribed drugs, with the aim of reducing and stopping unnecessary drug treatment." The rationale behind this position is detailed on pages 26 and 27 of this document - basically, the weakness of the evidence in favour of drug treatment ("the relative immaturity of intervention research in this field") and the seriousness of potential side effects.
• The latest Cochrane review, cited in this article and mentioned above, as best as I can judge from its abstract, makes plain that the existing evidence for drug intervention, though "suggesting" efficacy, is too weak to be decisive. To be clear, it and the NICE guideline are not describing the reported clinical results as weak, but the overall body of evidence as weak.

Due to the constraints imposed by the WP:MEDRS guideline we are obliged to represent this (currently) consensus view of best practice, though the reasons for avoiding drug intervention - dearth of high quality studies/seriousness of side effects - could be made clearer.

Coccaro and Kavoussi's 1991 division of BPD into three clusters of symptoms--affective instability, transient psychotic phenomena, and impulsive aggressive behavior -- each susceptible to different classes of pharmacological agents is appealing but before it can be presented as a treatment approach here it will need to be supported by strong, rather than weak evidence, as assessed by authoritative reviews or national guidelines. I appreciate this must be frustrating if you are seeing predictable results using this paradigm, but, until national guidelines or recent authoritative reviews tell us otherwise, we cannot present drug treatment as anything other than unproven. --Anthonyhcole (talk) 05:47, 4 September 2011 (UTC)

@94.13.13.164 regarding experts - wikipedia has a number of doctors (including specialists) who edit. I am actually a psychiatrist so am quite familiar with the theories surrounding the pathogenesis and treatment of this disorder, as well as seeing what doctors actually prescribe, what patients are prescribed. There are times where my own observations vary from the published literature, but the role here is encyclopedia not groundbreaking medical journal. We are always keen to see new and interesting Review Articles - Cheers, Casliber (talk · contribs) 10:15, 4 September 2011 (UTC)

I have rewritten the medication section with a bit more detail, per the above discussion. --Anthonyhcole (talk) 00:01, 6 September 2011 (UTC)

Nice job, I think it encapsulates the state of play well. Casliber (talk · contribs) 02:23, 6 September 2011 (UTC)

Well, at least I got *somewhere* and the medication section was expanded well. While I don't agree with the recommendation of no drugs for BPD sufferers (the thought of no mood stabilizers for characteristically emotionally unstable people is a frightening thought, for me) at least there was some mention of mood stabilisers in there, which given the lack of relative strength of evidence versus say, antidepressants in the treatment of depression, I guess I will settle for. 109.73.66.52 (talk) 17:14, 8 September 2011 (UTC)James Brannigan

I am sorry but you are seriously confusing two meanings of the term "Mood stabilisation" which are quite distinct. When we use the term in psychiatry WRT lithium/valproate/carbamazepine, we mean the stabilising of the mood in bipolar, the swings of which take weeks to months. The sudden "mood swings" which people talk about with borderline personality are more properly called affect dysregulation and quite a different phenomenon entirely - this latter is likely more related to serotonin deficiency. The recommendation is not "no meds" as comorbidity is not uncommon. Casliber (talk · contribs) 20:16, 8 September 2011 (UTC)

I myself am sorry to sound so blunt when I state that you are with respect to affect dysregulation being more related to serotonin deficiency absolutely wrong. The article should, then, if you think thus, reflect fluoxetine's efficacy in treating BPD, as I mentioned many times above, but it does not. Either way, carbamazepine is without doubt the most effective remedy for this dysregulation; BPD is most likely a form of epilepsy rather than just a serotonin deficiency. (Co-morbid depression which may often be the case, possibly skews the data in favor of your conclusion.) Of course there are two meanings of mood stabilisation, one which is only used by medical professionals, and the other which most people would read as mood stabilisation. To "stabilise" anyone's "mood" is just that, to stabilise the mood, no more no less. Instead of the word "unstable", what would you like me to say? Affect-dysregulated? Given the relative obscurity (despite, indeed, its common occurrence) of borderline, we don't really have a full, established, well used vocabulary for its characteristics. Even the term "borderline" itself is, as I'm sure you know, a misnomer. I think we both know that we are talking about borderline here and not bipolar, I thought that was evident with my countless mentions of the word "borderline" as opposed to "bipolar", something indeed different entirely.

94.13.13.164 (talk) 16:37, 9 September 2011 (UTC)James Brannigan

BPD is not even remotely a form of epilepsy. Don't be absurd. — Preceding unsigned comment added by 184.100.223.149 (talk) 07:07, 17 September 2011 (UTC)

Ask Dr Leland Heller about that and he would tell you who is being absurd. — Preceding unsigned comment added by 94.13.13.172 (talk) 15:00, 19 October 2011 (UTC)

Re: Child Abuse

The section titled "Child Abuse" has some confusing language. Specifically: "They were also reported to have failed to provide needed protection, and neglected their child's physical care." Who are they, the person with BPD or the parents/caregivers of the person with BPD? I would fix this myself, but as there is no citation, I really don't know which is correct. Tarview (talk) 20:05, 4 November 2011 (UTC)

Seeing as how it's listed under causes, I'm guessing it would be the parents not providing adequate protection for those with BPD. Reub2000 (talk) 23:50, 4 November 2011 (UTC)

There is evidence that suggests that BPD and post-traumatic stress disorder (PTSD) are closely related.[26] this links to the following article "Impact of Co-Occurring Posttraumatic Stress Disorder on Suicidal Women With Borderline Personality Disorder" said article does not contain any claim that support this. The statement seems to imply that there is a similarity or resemblance between BPD and PTSD. The article only says that suicidal women with borderline personality disorder who also suffer from PTSD, have more extreme suicidal and self mutilating behaviour. — Preceding unsigned comment added by Slegten M (talk • contribs) 23:39, 6 November 2011 (UTC)